Steven J. Lester, MD; Matthew Baggott, BA; Susette Welm, MA; Nelson B. Schiller, MD; Reese T. Jones, MD; Elyse Foster, MD; John Mendelson, MD
The psychoactive stimulant 3,4-methylenedioxymethamphetamine (MDMA), also known as “ecstasy,” is widely used in nonmedical settings. Little is known about its cardiovascular effects.
To evaluate the acute cardiovascular effects of MDMA by using transthoracic two-dimensional and Doppler echocardiography.
Four-session, ascending-dose, double-blind, placebo-controlled trial.
Eight healthy adults who self-reported MDMA use.
Echocardiographic effects of dobutamine (5, 20, and 40 µg/kg of body weight per minute) were measured in a preliminary session. Oral MDMA (0.5 and 1.5 mg/kg of body weight) or placebo was administered 1 hour before echocardiographic measurements in three weekly sessions.
Heart rate and blood pressure were measured at regular intervals before and after MDMA administration. Echocardiographic measures of stroke volume, ejection fraction, cardiac output, and meridional wall stress were obtained 1 hour after MDMA administration and during dobutamine infusions.
At a dose of 1.5 mg/kg, MDMA increased mean heart rate (by 28 beats/min), systolic blood pressure (by 25 mm Hg), diastolic blood pressure (by 7 mm Hg), and cardiac output (by 2 L/min). The effects of MDMA were similar to those of dobutamine, 20 and 40 µg/kg per minute. Inotropism, measured by using meridional wall stress corrected for ejection fraction, decreased after administration of dobutamine, 40 µg/kg per minute, but did not change after either dose of MDMA.
Modest oral doses of MDMA increase heart rate, blood pressure, and myocardial oxygen consumption in a magnitude similar to dobutamine, 20 to 40 µg/kg per minute. In contrast to dobutamine, MDMA has no measurable inotropic effects.
Lester SJ, Baggott M, Welm S, Schiller NB, Jones RT, Foster E, et al. Cardiovascular Effects of 3,4-Methylenedioxymethamphetamine: A Double-Blind, Placebo-Controlled Trial. Ann Intern Med. ;133:969–973. doi: 10.7326/0003-4819-133-12-200012190-00012
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Published: Ann Intern Med. 2000;133(12):969-973.
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